Finding alternatives to opioids for service members and veterans in pain

For active duty service members, injury is part of life. Forget, for a moment, the risk of an attack while on deployment. Service members trek for miles with 50 pounds of equipment on their back. They haul tents, dig wells, build buildings. They push their bodies to the limit.

Improvements in battlefield medicine make surviving even a severe injury likely — but not without consequence. When injured service members return home, many face chronic pain with few treatment options. Prescription opioids offer relief, but are highly addictive. With prescription painkiller abuse on the rise, leadership at the U.S. Armed Forces is looking for new, non-drug alternatives to treat chronic pain, depression, and posttraumatic stress disorder (PTSD).

The grant is part of a $21.7 million initiative to study nonpharmacological approaches to pain and health conditions such as PTSD, funded by a collaboration between the National Center for Complementary and Alternative Medicine (NCCAM), the National Institute on Drug Abuse (NIDA), both of the National Institutes of Health; and the U.S. Department of Veterans Affairs (VA) Health Services Research and Development Division. Larson’s grant is funded by NCCAM.

Larson and her team will build on their NIDA-funded Substance Use and Psychological Injury Combat Study, earlier research they conducted with more than 643,000 Army active duty and National Guard/Reserve members. The new study will evaluate how chronic pain is experienced, treated, and how the type of treatment impacts long-term health-related outcomes.

Larson is interested in whether patients whose chronic pain is managed with complementary and alternative medicine, such as chiropractic therapy or mind/body counseling, are less likely to experience long-term depression or addiction compared to those whose pain is treated with opioids exclusively.

“This study will create a base of information on how chronic pain is managed,” Larson says. “It will replace anecdotal reports about opioid addiction among service members and veterans with estimates generated from real information. We hope information from this study will motivate military treatment facilities and veterans medical centers to make available more specialized pain treatment programs that offer alternatives to high dose, long-term use of opioids as the only option for pain.”